Preface for the special series on “Tobacco and Addiction”

In this special series of the Journal of Public Health and Emergency, we delve into the intricate world of nicotine and addiction, drawing together a collection of articles that investigate the diverse aspects of these intertwined phenomena. As smoking and other forms of nicotine use continue to contribute to significant morbidity and mortality worldwide, it is imperative that the medical and scientific communities come together to better understand the underlying mechanisms, challenges, and potential interventions.

The articles in this series encompass a wide range of topics, including the unique aspects of vaping dependence, the role of e-cigarette product characteristics in addiction, the role of contraband cigarettes, and an examination of the role of religion in smoking cessation. By covering this breadth of research, we aim to provide a comprehensive and nuanced understanding of nicotine and addiction, and inspire innovative strategies for prevention and treatment.

Two articles focus on the novel delivery mechanisms of nicotine through e-cigarettes. Maloney et al. (1) argue that more attention is needed on the product characteristics of e-cigarettes and how those characteristic contribute to addiction and smoking cessation. E-cigarettes and more generally electronic nicotine delivery systems are heterogenous products. Different devices are able to deliver vastly different levels of plasma nicotine at different rates. For studies conducting randomized controlled trials, it is critical that these product characteristics be considered and more potent products used for the trials to maximize effectiveness. Beyond the effect on trials, consideration of product characteristics is important for monitoring and development of regulation that maximizes the use of e-cigarettes as a smoking cessation device and limiting the impact on never smoking youth. Sanchez et al. (2) similarly review the unique characteristics of e-cigarette devices—here with a focus on helping youth who want to quit e-cigarettes. This article notes that e-cigarettes have different product and social characteristics compared to smoking cigarettes. E-cigarettes are “discreet”—they can be easily hidden and used in many more situation that could cigarettes—and yet not “discrete” unlike cigarette where the unit dose, the cigarette, is easily identified, e-cigarettes can be used continuously. The combination of discreet yet not discrete means that users may be less aware of their level of addiction and efforts to identify the burden of addiction itself may be an effective intervention.

Ortiz-Prado et al. (3) examine the effect of smuggled cigarettes in Ecuador. In Ecuador, similar to other countries, smuggled cigarettes are an issue driven by the tobacco industry. Smuggling undermines the effects of tobacco control policies, reduces the price of cigarettes to users increasing use and the health burden. Tracking and tracing controls are needed to limit the sale of smuggled tobacco.

Finally, King et al. (4) take an in-depth look at the role of the Church of Jesus Christ of Latter-Day Saints in tobacco control. Use of tobacco is very low among members of the Church and there has been very limited research examining how religious institutions can contribute to lowering the burden of tobacco-related harms. This underexplored area shows how effectively religious institution can effectively regulate tobacco use in a community.

In the quest to reduce the global burden of tobacco-related disease, it is essential to consider the multifaceted nature of nicotine addiction, which extends beyond the physiological and psychological dimensions to encompass social, cultural, and economic factors. By illuminating these complexities, this supplement seeks to foster a deeper appreciation of the challenges faced by individuals, communities, and policy makers in addressing nicotine addiction, and to stimulate further research and collaboration in this critical area of public health.

Acknowledgments

Funding: None.

Footnote

Provenance and Peer Review: This article was commissioned by the editorial office, Journal of Public Health and Emergency for the series “Tobacco and Addiction”. The article did not undergo external peer review.

Conflicts of Interest: The author has completed the ICMJE uniform disclosure form (available at https://jphe.amegroups.com/article/view/10.21037/jphe-2023-02/coif). The series “Tobacco and Addiction” was commissioned by the editorial office without any funding or sponsorship. MC served as an unpaid Guest Editor of the series and serves as an unpaid editorial board member of the Journal of Public Health and Emergency from August 2020 to July 2024. The author has no other conflicts of interest to declare.

Ethical Statement: The author is accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

References

1. Maloney SF, Hoetger C, Rudy AK, et al. Randomized controlled trials using electronic nicotine delivery systems as smoking cessation aids require an accurate, empirically-based understanding of the nicotine delivery profile of the products under study. J Public Health Emerg 2021;5:20. [Crossref] [PubMed]
2. Sanchez S, Chaiton M. Is vaping dependence like smoking dependence? —A literature review highlighting implications for vaping cessation among youth. J Public Health Emerg 2021;5:27. [Crossref]
3. Ortiz-Prado E, Teran E, Cevallos-Sierra G, et al. Anti-tobacco policy and the smuggled cigarettes, a hidden problem in Ecuador. J Public Health Emerg 2022;6:10. [Crossref]
4. King JH. Tobacco—not for the body: epidemiologic understanding of tobacco use among members of the Church of Jesus Christ of Latter-day Saints from a Mormon perspective. J Public Health Emerg 2023;7:7. [Crossref]

Michael Chaiton